Goa government steps up preparation to meet paediatric bed target

PANAJI: As experts warn that a possible third wave of Covid-19 may strike quicker than expected, concern over the state’s preparedness has risen in the state, as many fear that it may hit a larger portion of the paediatric population, even though others won’t be spared either.
“In the second wave, besides those above 45, people in the 18-44 age group were also affected in big numbers,” said a senior doctor who is member of the state’s expert committee. While children did contract Covid-19 during both the waves, it was a small number — in the first wave, 7-8% of those testing positive were kids, while in the second, that rose to 12%.

The government is preparing on the assumption that a little more than 12% of the positive cases will be children when the third wave strikes. As it stands, those under 18 are the only category not eligible for the Covid-19 vaccine.
During the past two meetings of the task force committee held under the chairmanship of chief minister Pramod Sawant, the estimates of neonatal and paediatric ICU beds have been finalised. A deficit of P-ICU beds, they said, was marginal, and is proposed to be met by adjusting existing adult ICU beds.
“Assuming that more children will be affected, there will be fewer adult cases. So, a provision has been made that 20% of the ventilators meant for adults can be adjusted for paediatric patients with new props and settings changed,” he said.
The state has adopted the guidelines of the Indian academy of paediatrics (IPA) for minimum standards of PICUs. Also, the guidelines issued by the Union ministry of health and family welfare in June for evidence-based management of children have been adopted. “The committee has decided that these guidelines will be applied everywhere, and the task force has given its nod,” he said.
An integrated voice response system (IVRS) introduced by a company called ‘Step One’ for home management of cases is being considered. “Expert committee members have attended a presentation made by the company, and gave suggestions on how to improve it,” he said.
One of the important suggestions by the expert committee was that children under five be monitored exclusively by paediatricians. Children above five years of age will be monitored by general doctors including paediatricians through IVRS.
“The overall picture worldwide is that even though children may get Covid-19, less than 1% of them get multisystem inflammatory syndrome in children (MIS-C). The majority will be asymptomatic or mild infection, and will recover with minimum medication.”
The worldwide picture, he said, showed that 98% of children hospitalised for Covid-19 recover and go home.He said that paediatricians in private practice have volunteered to undergo training in ventilation management of children at GMC and district hospitals. Still more have agreed to do telemonitoring of home-isolated children.